Arbitration Quality Analyst

Capitol Bridge, LLC.; Columbia (SC); Presencial; USD 60.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, vision, and pharmacy

401(k) retirement plan with company m

Paid time off

Paid holidays

Descripción de la vacante

Capitol Bridge is seeking a dynamic Arbitration Quality Analyst to review arbitration cases and rationales against approved quality standards. The role focuses on documenting findings, applying correction paths, and escalating potential compliance issues when needed.

The position involves collaboration with Quality, Training, Compliance, Reporting, and program leadership to ensure accuracy and timeliness in reviews and closeout decisions.

Formación

• Experience reviewing complex written case decisions or regulated documentation.
• Strong attention to detail and ability to explain findings neutrally and clearly.
• Attorney credentials to be specified for any subset of positions assigned credentialed legal review.

Responsabilidades

• Review Arbitration cases and rationales against approved quality standards and document findings before or after closeout as assigned.
• Perform assigned quality reviews using the approved checklist and sampling or risk rules.
• Record clear findings, evidence, and required corrections in the designated system.
• Return work through the defined correction path and verify corrections when assigned.
• Participate in calibration and report recurring defects or unclear standards.

Conocimientos

Attention to detail

Written communication

Legal review experience

Descripción del empleo

About Capitol BridgeFounded in 2012, Capitol Bridge is based in Arlington, Virginia and has proven expertise providing independent medical reviews, records/data management services, medical coding, administrative staffing and eligibility reviews. Capitol Bridge, LLC is seeking a dynamic and experienced individual to join our team as an Arbitration Quality Analyst.Benefits Include:Medical, dental, vision, and pharmacy benefits with employer contributionCompany-sponsored life insurance401(k) retirement plan with company matchPaid time offEmployee Assistance ProgramPaid trainingPaid holidaysPosition summaryReview Arbitration cases and rationales against approved quality standards and document findings before or after closeout as assigned.Key responsibilitiesPerform assigned quality reviews using the approved checklist and sampling or risk rules.Record clear findings, evidence, and required corrections in the designated system.Return work through the defined correction path and verify corrections when assigned.Participate in calibration and report recurring defects or unclear standards.Escalate potential compliance issues without making unauthorized closeout or payment decisions.QualificationsExperience reviewing complex written case decisions or regulated documentation.Strong attention to detail and ability to explain findings neutrally and clearly.Attorney credentials to be specified for any subset of positions assigned credentialed legal review.Measures of successReview accuracy and timelinessComplete documentationCalibration participationRepeat error trendsWorking relationshipsWorks across the assigned lane and with Quality, Training, Compliance, Reporting, and program leadership as needed. Follows approved decision rights, confidentiality requirements, and escalation paths.Screenings Required:You will receive requests for background check, fair credit check, and drug screen regarding this employment opportunity. Respond to all requests quickly as we anticipate filling our vacancies quickly and non-responses may result in disqualification for this opportunity.*Please be aware that our organization and our client adhere to stringent security regulations, necessitating a thorough background screening process for all potential hires. We value transparency and want to inform you that this screening may result in a delay of at least 60 days prior to onboarding. Rest assured, we are committed to maintaining a secure and compliant work environment. We appreciate your understanding and cooperation as we prioritize the safety and confidentiality of our operations.Reasonable Accommodation:If you require alternative methods of application or screening, you must approach the employer directly to request this. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.EEO Statement:Capitol Bridge is an Equal Opportunity Employer. All employment decisions at CB are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.